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Diane Maheux, FHFMA, FACHE INTRODUCTION TO FINANCIAL STATEMENTS FINANCIAL STATEMENTS Balance Sheet Income Statement (aka Statement of Operations, aka Statement of Revenues & Expenses) Statement of Cash Flows Financial Statement Notes BALANCE SHEET The balance sheet is presented from a specific point of time – typically the last day of the month or the last day of the fiscal year. Assets = Liabilities + Equity Equity in for-profit entities Equity in Non Profits is called “Net Assets” 20x2 20x1 Assets Current Assets Cash & Cash Equivalents 5,877 Marketable Securities 15,836 Accounts Receivable, Net Total Current Assets Current Portion of LT Debt 1,470 1,750 10,740 Accounts Payable & Accrued Expenses 5,818 5,382 15,100 14,194 Estimated Third Party Settlements 2,143 1,942 2,670 2,586 Other Current Liabilities 1,969 2,114 38,364 33,397 11,400 11,188 23,144 24,014 3,953 3,166 38,497 38,368 70,526 65,418 Temporarily Restricted 2,115 2,470 Permanently Restricted 3,588 3,533 76,229 71,421 Assets Limited to Use Internally designated for capital use Held by Trustee Long term investments Property & Equipment, net Other Assets Total Current Liabilities Long term Debt, net of current portion 12,000 12,500 6,949 7,341 18,949 19,841 4,680 4,680 51,038 50,492 1,695 1,379 Other Liabilities Total Liabilities Net Assets Unrestricted Total Net Assets Total Assets 20x1 Liabilities Current Liabilities 4,758 Other Current Assets 20x2 114,726 109,789 Total Liabilities & Net Assets 114,726 109,789 ASSETS – WHAT ARE THEY M. Nowicki defines assets “as economic resources that provide or are expected to provide benefit to the organization” Hmm… does that really help you? Assets include tangible items: cash, investments, accounts receivable, plant, property, equipment, and inventory As well as include intangible: goodwill Nowicki, M. (2004). The Financial management of hospitals and healthcare organizations. Health Administration Press: Chicago, Illinois. CURRENT VS. NONCURRENT Current Assets – have an economic life of less than 1 year; those items that can be quickly turned into cash Cash, Cash equivalents (ex. CD’s, t-bills) short term investments, assets set limited to use; patient receivables, Other current Assets Long Term Assets – have an economic life of greater than 1 year Assets limited to use (money set aside for specific purpose); Long term investments; Property & Equipment (net value); & other assets HOW IS THE BALANCE SHEET ORGANIZED? Ordered by Liquidity – Current Assets are listed first Long Term assets are listed afterwards Assets Current Assets Cash & Cash Equivalents Marketable Securities Accounts Receivable, Net Other Current Assets Total Current Assets Assets Limited to Use Internally designated for capital use Held by Trustee Long term investments Property & Equipment, net Other Assets Total Assets 20x2 20x1 4,758 15,836 15,100 2,670 38,364 5,877 10,740 14,194 2,586 33,397 12,000 6,949 18,949 4,680 51,038 12,500 7,341 19,841 4,680 50,492 1,695 114,726 1,379 109,789 LIABILITIES Liabilities are debts of the organization Current Liabilities – are debts (payments) that are due in less than 1 year Salaries Payable, Accounts Payable, Taxes Payable, Current Portion of Long Term Debts (Bonds or Mortgages) Long Term liabilities – are the debts are due greater than 1 year Other Liabilities, Bonds Payable, Mortgage Payable SAMPLE LIABILITIES… 20x2 20x1 Liabilities Current Liabilities Current Portion of LT Debt 1,470 1,750 Accounts Payable & Accrued Expenses 5,818 5,382 Estimated Third Party Settlements 2,143 1,942 Other Current Liabilities 1,969 2,114 11,400 11,188 23,144 24,014 3,953 3,166 38,497 38,368 Total Current Liabilities Long term Debt, net of current portion Other Liabilities Total Liabilities EQUITY (NET ASSETS) For Profit Entities: Owner’s Equity/Stockholder’s Equity/Partnership Equity Retained earnings Not for profit entities = Net Assets Unrestricted Net assets Temporarily Restricted Net Assets Permanently Restricted Net Assets NET ASSETS REPORTED Net Assets Unrestricted 70,526 65,418 Temporarily Restricted 2,115 2,470 Permanently Restricted 3,588 3,533 76,229 71,421 Total Net Assets Total Liabilities & Net Assets 114,726 109,789 STATEMENT OF OPERATIONS Statement of Operations is a.k.a. Income Statement Net Patient Revenues + Other Operating Revenue - Operating Expenses = Net Operating Income +(-) Non Operating Revenues & Expenses = Increase(Decrease) in Net Assets/Equity NET PATIENT REVENUES Gross Patient Revenue for the period* - Estimated Contractual Adjustments - Estimated Bad Debt - Estimated Charity Care = Net Patient Service Revenue *Does NOT include Premium Revenue from Capitated contracts WHAT ARE OTHER OPERATING REVENUES? Cafeteria sales Interest Contributions/Donations Parking receipts Rental Receipts Gift Shop (possibly) Other miscellaneous revenues Premium Revenue (though may be separated from Other Op revenue in its own category) OPERATING EXPENSES Salaries Professional Salaries Benefits Supplies (Drugs may/may not be inc) Depreciation Interest Utilities Other expenses NON OPERATING EXPENSES/INCOME Considered “below the line” Change in Unrealized gains/losses Net assets released from restrictions for the purchase of property & equipment Can include transfers to a parent/holding company SAMPLE STATEMENT OF OPERATIONS External Income Statement 2x12 Net Patient service Revenue Premium Revenue Other Revenue Total Operating Revenues 74,299 2,601 76,900 Expenses Salaries 45,132 Benefits 9,132 Supplies 9,035 Depreciation 3,567 Interest 2,200 Other 4,576 Total Expenses Operating Income (Loss) Changes in net unrealized Gains/Losses Increases to unrestricted net assets 73,642 3,258 300 3,558 INTERNAL VS. EXTERNAL STATEMENT OF OPERATIONS External Financial Statements – Balance Sheet – reported in net Revenue is reported in Net Expense categories are broken down as extensively, very high level Internal Financial Statement Balance Sheet broken down more Revenue – reported in gross with contractual detail (sometimes) Expense Categories may be further broken down STATEMENT OF CASH FLOWS Statement of Cash Flows aka Sources and Uses of Cash Broken down into 3 Categories: Cash flows from Operating Activities Cash flows from Investing Activities Cash flows from Financing Activities STATEMENT OF CASH FLOWS Cash flows from operating activities: Change in net assets 3,558 Provision for bad debts 1,000 Increase in patient accounts receivable (906) Increase in other current assets (84) Increase in Accounts payable 436 Increase in third party settlements 201 Decrease in other current liabilities (145) Increase in Other liabilities Net Cash flow provided by Operating Activities 787 4,847 Cash flows from investing activities: Increase in marketable securities (5,096) Net cash flows provided by Investing Activities (5,096) Cash flows Financing Activities Decrease in LT Debt (870) Net cash flows provided by Financing Activities (870) Net increase (decrease) in cash (1,119) Cash beginning of the year 5,877 Cash end of the year 4,758 WHY IS STATEMENT OF CASH FLOWS IMPORTANT? Cash is king – so how are we functioning as an organization? Is the cash coming from revenues? Are we borrowing to stay afloat? Are we financing to keep the operations going? DON’T FORGET THE NOTES TO THE FINANCIAL STATEMENTS Provides information in better detail What is really going on? Changes in payer mix, changes in liabilities… any lawsuits pending? Provides explanations to changes that may be occurring that the organization is responding to FURTHER CONTACT INFORMATION Diane Maheux, FACHE, FHFMA Controller, Memorial Hospital [email protected] Put in “HFMA Financial Statements” in the Subject Line